Muscles of the Lower Extremity Flashcards
Gluteal Compartment muscles
Gluteus Maximus Gluteus Medius Gluteus Minimus Quadratus Femoris Superior Gemellus Obdurator Internus Piriformis Inferior Gemellus Tensor of Fascia Lata
Anterior Thigh Muscles, innervation
Femoral Nerve (L2-L4) Femoral Artery Sartorius "Quadriceps": Rectus Femoris Vastus Medialis/Intermedialis/Lateralis
Medial Thigh Muscles, innervation
Obdurator Nerve mostly (L2-L4) Obdurator artery, possibly femoral artery Adductor Magnus/Longus/Brevis Gracilis Pectineus Obdurator Externus
Posterior Thigh, innervation
Tibial nerve (L4-S3) Profundis femoris artery "Hamstrings": Semitendonosus Semimembranosus Biceps Femoris (long and short head)
Extension of Hip
Gluteus Maximus --> major "Hamstrings": Semitendonosus Semimembranosus Biceps Femoris (long head only)
Flexion of Hip
Iliopsoas (major)
Rectus Femoris
Sartorius* two joint muscle
Tensor of Fascia Lata
Abduct Hip
Gluteus Medius
Gluteus Minimus
Tensor of Fascia Lata
Adduct Hip
Adductor Magnus (major) /Brevis/Longus Gracilis* two joint muscle Pectineus
Lateral Rotator Hip
Gamellus (superior/inferior) Obdurator (externus/internus) Quadratus Femoris Piriformis Sartorius
Medial Rotation Hip
Medial fibers of gluteus medius/minimus
Posterior Compartment of Leg, innervation
Tibial Nerve (L4-S3)
Gastronemius, Soleus, Plantaris
Popliteal, Tibial Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus
Posterior tibial artery
Lateral Compartment of Leg, innervation
Fibularis Longus, Fibularis Brevis
Innervated by superficial fibular nerve (L5-S2)
Peroneal artery
Anterior Compartment of Leg, innervation
Tibial Anterior, Extensor Digitorum Longus, Extensor Hallucis Longus, Fibularis tertius
Deep fibular nerve, along with dorsum of foot
(L4-S2)
Anterior tibial artery
Extensors of Knee
“Quadriceps”
Rectus Femoris
Vastus Lateralis, medialis, intermedialis
Flexion of Knee
"Hamstrings": Semitendonosus Semimembranosus Biceps Femoris (long and short heads) Popliteus Gastronecmius* 2 joint Plantaris* 2 joint
True extension of ankle
Dorsi-flexion
True flexion of ankle
plantar-flexion
inversion of ankle
raising medial side
eversion of ankle
raising lateral side
Muscles for extension/dorsi-flexion
tibialis anterior extensor hallucis longus extensor digitorum longus fibularis tertius (sometimes)
Muscles for flexion/plantar-flexion
Tibalis posterior flexor hallucis longus flexor digitorum longus gastronemeus soleus plantaris fibularis longus/brevis (sometimes)
Inversion of Foot
Tibialis Anterior (deep fibular nerve) /Tibialis Posterior (tibial nerve)
Eversion of foot
Fibularis longus/brevis/tertius
Easier to lose function of eversion than inversion. because mostly by the same nerve (superficial fibular nerve). The tertius is supplied by the deep fibular nerve (anterior compartment of leg) but it’s only a weak everter.
Talo-crural joint
ankle joint
genual joint
knee joint
acetabulofemoral joint
hip joint
pectineus muscle innervation
femoral and obdurator, even though in medial thigh compartment
adductor magnus innervation
posterior part (ischiocondular portion) gets tibial nerve, rest gets femoral nerve because in anterior thigh compartment
Only muscle to attach to lesser trochantar of femur
Iliopsoas
Gluteus Maximus innervation
Inferior gluteal nerve (L5-S2)
inferior and superior gluteal artery
Gluteus medius innervation
Superior gluteal nerve (L4-S1)
Superior gluteal artery
Gluteus minimus innervation
Superior gluteal nerve (L4-S1)
superior gluteal artery
Quadratus Femoris innervation
Nerve to quadratus femoris (L4-S1)
Superior Gemellus innervation
Nerve to obdurator internus (L5-S2)
Obdurator Internus innervation
Nerve to obdurator internus (L5-S2)
Inferior Gemellus innervation
Nerve to quadrator femoris (L4-S1)
Piriformis innervation
nerve to piriformis (L5-S2)
Tensor of fascia lata
superior gluteal nerve (L4-S1)
inferior gluteal artery
Contents and location of the adductor canal
Between apex of femoral triangle and adductor hiatus (near knee)
contains femoral artery and vein, saphenous nerve
Adductor hiatus
In tendon of adductor magnus near knee, femoral vessels pass posteriorly where name changes to popliteal vessels
What contributes to quadriceps tendon
Rectus femoris, vastus lateralis/intermedialis/medialis
Innervation of short head of biceps femoris
Common fibular nerve (L5-S2)
Borders of the femoral triangle
Inguinal ligament on top, medial adductor longus, lateral is sartorius
NAVL in femoral triangle/sheath
femoral nerve (not in femoral sheath), artery, vein, lymphatics from lateral to medial
what happens in the saphenous opening
The saphenous vein drains into the femoral vein after passing through a hole in the anterior fascia lata
pes ansenerious
gooses foot, common tendinous attachment of sartorius, gracilis, semitendonosus on lateral side of tibia
distal attachment of adductors
linea aspera of femur
Joints between tibia and fibula
Three joints:
Proximal –> synovial
Middle and Distal –> syndesmosis (fibrous)
Purpose of superior and inferior extensor retinaculum
Holds the tendons of anterior compartment (ankle extensors) in place in the foot
What gives rise to the dorsalis pedis artery
anterior tibial artery on dorsum of foot
Purpose of superior and inferior peroneal retinaculum
Holds the tendons of peroneal longus and brevis in place in the foot
Popliteus muscle specific function
Unlocks and initiates flexion of the knee.
Location: between joint cavity and lateral collateral ligament. Runs lateral to medial as you go inferior. Tendon attaches to lateral side of femur, provides more protection to the lateral side of genual joint.
Tom dick and harry in foot vs in calf, medial to lateral.
In foot: Flexor hallucis longus, tibialis posterior, flexor digitorum longus.
In calf: Flexor digitorum longus, tibialis posterior, flexor digitorum longus.
Order switches when the tendons wrap around the medial malleolus.
Notice tibialis posterior is always in the middle
Tendo-calcaneus
The achilles tendon. Gastronemius and soleus contribute, reaches down to calcaneus.
What separates the anterior and posterior compartments of leg
Interosseous membrane
Ligaments of acetabulofemoral/hip joint
Iliofemoral, Ischiofemoral, Pubofemoral
Acetabular labrum – Ring of cartilage around acetabulum (hip socket) increase articular surface area
parts of knee joint
Two tibia-femoral joints (medial and lateral) –> weightbearing
One patella femoral joint –> helps quadriceps gain leverage
What type of bone is patella
semasoid, bc grows inside tendon
All ligaments of knee
Posterior/Anterior cruciate ligaments
Lateral/Medial collateral ligaments
medial/lateral menisci
Attachments of PCL and ACL
ACL attached to anterior tibia and posterior lateral femur, also to medial meniscus
PCL to posterior tibia and anterior medial femur
Medial and Lateral placements still between two condyles
Lateral Collateral Ligament vs. Medial Collateral Ligament
Lateral Loose, injured less often, stronger and narrower
Medial connected to medial meniscus, injured more often, weaker, thin and broad
Unhappy triad of the knee
MCL, medial meniscus, ACL. All attached to each other. All injured at the same time when there is a lateral push to the knee on a fixed leg.
Medial meniscus vs. Lateral meniscus
Medial is Cshaped, Lateral is O shaped
Both attached to tibia via coronary ligaments
Both help in articular efficiency
Prepatellar bursa
On top of patella
Suprapatellar bursa
Under quadriceps tendon, communicates with joint cavity
Infrapatellar bursa
Under patella
Most common ankle sprain
Inversion, affecting lateral ligament, specifically anterior talofibular ligament or second most common calcaneofibular ligament
Three lateral ligaments of ankle
anterior talofibular ligament
calcaneofibular ligament
posterior talofibular ligament
Deltoid ligament of ankle
Medial ligament of ankle, has many ligaments that make it up
Calcaneus
Heel bone
Talus
The tarsal bone where the tibia and fibula articulate to
Plantar calcaneonavicular ligament
Spring Ligament
key in maintaining the longitudinal arch
Present on the medial aspect
Pes planus
Flat footedness, usually caused by the spring ligament
The 8 muscles that cross two joints
Gracilis –> Flex knee, adduct hip,
Biceps Femoris (long head) –> extend hip, flex knee
Semimembranosus –> extend hip, flex knee
Semitendonosus –> extend hip, flex knee
Rectus Femoris –> flex hip, extend knee
Sartorius –> flex hip, flex knee
Gastronemius –> plantar-flex (flexion) of ankle, weak flexion of knee
Plantaris –> plantar flex of ankle, flexion of knee
Lasegue Sign
Sciatic nerve disease. Pain with extension of hip/knee
Differentiation on the two sides
Trendelenberg Gait
Damage to superior sciatic nerve
Damage to abductor function, sway side to side when walking bc you wouldn’t be able to maintain center of gravity
Foot-Drop
Damage to common fibular
Cannot extend the ankle, leads to violent drop of foot.
sensory of heel
medial calcaneal branch of tibial nerve
Sensory for medial plantar surface, first three toes
medial plantar branch of tibial nerve
sensory for lateral plantar surface, last two toes
lateral plantar branch of tibial nerve
sensation for dorsum of foot
superficial fibular nerve
Two extrinsic foot muscles and innervations
Extensor digitorum brevis, Extensor Hallucis Brevis
Innervated by the deep fibular nerve
Extend the toes
Three arches in foot
medial, longitudinal, lateral transverse
